It’s been crazy out there. Thousands of people are dying daily from coronavirus disease 2019 (COVID-19) amidst skeptics saying the mortality data are phony — even some physician assistants (PAs) and nurse practitioners (NPs)! But with the new Biden administration, it’s a new day. Science has returned as the queen and it feels good.
I’ve been reaching out to my PA and NP colleagues to find out how they are feeling about their utilization in the time of COVID-19 and asking the following questions:
- Are PAs and NPs being used properly?
- Are PAs and NPs getting the respect they deserve for their role as front-line workers?
- Is their work being dismissed by the usual set of people against advanced practice providers (APPs)?
I’ve talked to PAs and NPs in just about all settings of medicine: primary care, emergency medicine, and specialty practices. The message is loud and clear: PAs and NPs are being given the chance to play a key role in diagnosing and treating COVID-19.
Some might say that this role was born out of necessity and that even the people who oppose PAs and NPs had no choice but to lean on us because we were available. And maybe that’s true in some cases, but I don’t think it’s the norm. In fact, I conclude, based on my experience and what I hear, that more than ever before we are being allowed to play an essential role in solving the thorny problems of our time.
In my specialty of opioid use disorder care, PAs and NPs are the answer to the problem of how we treat these patients. Opioid treatment programs (OTPs) have led the way in how we manage our patients, getting them the diagnosis and treatment they need while practicing social distancing and staggering patients in and out of the clinic to reduce the spread of the virus.
It has not been easy, but with the cooperation of oversight bodies such as state health boards, Drug Enforcement Administration, boards of pharmacy, and other groups, we’ve been able to get take-home doses for more patients, in spite of the super-restrictive rules that govern take-home drugs in OTPs. We’re working to gather data, and so far we’re seeing that there has not been an alarming increase in overdoses or other medication-security concerns related to increased take-home drugs provided for patients.
I do fear that after the pandemic is over, some practitioners who usually lack support for our work will step in and say “step aside, the MDs are back, now you all get back to taking blood pressures, etc.”
But I don’t really think that is going to happen. First of all, PAs and NPs were doing more even before COVID-19. The respect and integration of our roles have been growing exponentially, at least where I come from in OTPs. And when COVID-19 clears, our value will be more appreciated than ever, particularly in light of how we have performed during the pandemic.
In the end, I hope that our high-performance work during the pandemic will help blaze the trail to professional progress for all PAs and NPs. It’s not like anyone needs to do us a favor, it’s just that the medical community needs to acknowledge the value we bring, every single day, both pre- and postpandemic, to the health of our communities, and to the medical teams in which we play such an important role.
One of the values that PAs and NPs bring to the table every single day is the rubber-meets-the-road foundational belief that it’s not about us: it’s about the patients, the ones we serve every day. I’m not saying we’re the only professions to believe this, but I am saying that from my perch, no other medical or health professions excel more than we do in remembering why we’re here. And that’s for our patients.
Jim Anderson, PA-C, MPAS, DFAAPA, is a physician assistant working in addiction medicine in Seattle.
